Compassion Fatigue Webinar Evaluation Survey

Please take a moment to provide feedback about the webinar. We hope to use your confidential responses to improve this program in the future. If you prefer, you can print this survey out and FAX your responses to the Mental Health Association at 561-832-3900. Thank you!

1. How would you rate the webinar program on Compassion Fatigue held on March 23, 2010?

	Not at all	Not very highly	Somewhat highly	Highly
Informative	*How would you rate the webinar program on Compassion Fatigue held on March 23, 2010? Informative Not at all	Informative Not very highly	Informative Somewhat highly	Informative Highly
Interesting	Interesting Not at all	Interesting Not very highly	Interesting Somewhat highly	Interesting Highly
Useful	Useful Not at all	Useful Not very highly	Useful Somewhat highly	Useful Highly

2. Please rate your level of understanding about the following topics:

	1= no understanding	2	3	4	5	6	7=I knew all this already
How to recognize symptoms of compassion fatigue	*Please rate your level of understanding about the following topics: How to recognize symptoms of compassion fatigue 1= no understanding	How to recognize symptoms of compassion fatigue 2	How to recognize symptoms of compassion fatigue 3	How to recognize symptoms of compassion fatigue 4	How to recognize symptoms of compassion fatigue 5	How to recognize symptoms of compassion fatigue 6	How to recognize symptoms of compassion fatigue 7=I knew all this already
The need to care for yourself as care provider	The need to care for yourself as care provider 1= no understanding	The need to care for yourself as care provider 2	The need to care for yourself as care provider 3	The need to care for yourself as care provider 4	The need to care for yourself as care provider 5	The need to care for yourself as care provider 6	The need to care for yourself as care provider 7=I knew all this already
Ways to reduce stress	Ways to reduce stress 1= no understanding	Ways to reduce stress 2	Ways to reduce stress 3	Ways to reduce stress 4	Ways to reduce stress 5	Ways to reduce stress 6	Ways to reduce stress 7=I knew all this already

3. Satisfaction ratings

	1= not at all satisfied	2	3	4	5	6	7= Very Satisfied
Topic	*Satisfaction ratings Topic 1= not at all satisfied	Topic 2	Topic 3	Topic 4	Topic 5	Topic 6	Topic 7= Very Satisfied
Length	Length 1= not at all satisfied	Length 2	Length 3	Length 4	Length 5	Length 6	Length 7= Very Satisfied
Speakers	Speakers 1= not at all satisfied	Speakers 2	Speakers 3	Speakers 4	Speakers 5	Speakers 6	Speakers 7= Very Satisfied
Overall	Overall 1= not at all satisfied	Overall 2	Overall 3	Overall 4	Overall 5	Overall 6	Overall 7= Very Satisfied

4. Name three things you will do differently because of this program.

Name three things you will do differently because of this program.

5. What would you change to make this discussion better?

What would you change to make this discussion better?

6. If you are interested in participating in a workshop to learn more about stress-reducing techniques, please provide contact information below.

If you are interested in participating in a workshop to learn more about stress-reducing techniques, please provide contact information below. Name
EMAIL address
Phone number

7. I would prefer the following format for any workshop to learn stress reducing strategies:

I would prefer the following format for any workshop to learn stress reducing strategies: In-person workshop

Webinar

I am not interested at this time

Other (please specify)

8. What other webinar or workshop topics would you be interested in attending in the future related to health and mental health?

What other webinar or workshop topics would you be interested in attending in the future related to health and mental health?

9. We know that many Palm Beach County residents are feeling a great deal of stress. Please rate the areas you feel most stress in your world.

We know that many Palm Beach County residents are feeling a great deal of stress. Please rate the areas you feel most stress in your world. My work How to pay for things I need. My children My friends	The economy in general Cutbacks in programs Cost of health care Lack of mental health care
Other (please specify what stresses you out)

10. How do you cope with stress?

How do you cope with stress? Gardening Baking Yoga Reading	Aromatherapy Motorcycle riding Cognitive Behavioral Therapy Medication
Other (please list as many as you can think of)

11. What county do you live in?

What county do you live in?

12. Gender

Gender Male

Female

13. Age

Age 1-17

18-35

36-45

46-55

56-65

66-75

76-85

86-95

96-100

100+

14. Ethnic Origin

Ethnic Origin Black

White

Hispanic

Haitian

Asian

Guatemalan

Other